Stereotactic thalamotomy in the treatment of essential tremor of the upper extremity: reassessment including a blinded measure of outcome.
J Neurol Neurosurg Psychiatry
; 66(6): 772-5, 1999 Jun.
Article
em En
| MEDLINE
| ID: mdl-10329753
ABSTRACT
The effectiveness of high frequency stimulation of the thalamic nucleus ventralis intermedius (Vim-HFS) for treatment of tremor has been studied by blinded assessment. The effectiveness of thalamotomy for essential tremor of the upper extremity by use of a blinded measure of outcome is now reported. Thalamotomy was performed in 21 patients (three operated on bilaterally) with medically intractable, essential tremor. Assessments of function, handwriting/drawing, and tremor amplitude were done before and at 3 and 12 months after surgery. The handwriting/drawing score was rated by a neurologist blinded to patient identity, laterality, and operative status. By comparison with baseline, both the total functional score and the total score from blinded assessment of handwriting/drawing improved significantly at 3 and 12 months after surgery. The two scores were significantly correlated, suggesting that the blinded assessment is a good predictor of a total disability from tremor. Complications after unilateral thalamotomy included transient dysarthria, permanent perioral numbness, and permanent mild disequilibrium in one patient each. Permanent mild dysarthria occurred in two of three patients operated bilaterally. Thus a blinded assessment of outcome establishes that unilateral thalamotomy is an effective, safe procedure for the treatment of essential tremor.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tálamo
/
Tremor
/
Técnicas Estereotáxicas
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Estados Unidos